Choroidal changes in eyes treated with high-dose systemic corticosteroids for optic neuritis

Lee, Jun Hyuk; Lee, Ji Young; Ra, Ho; Kang, Nam Yeo; Baek, Jiwon

doi:10.18240/ijo.2020.09.15

Cited by 6 publications

(4 citation statements)

References 24 publications

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“…Other studies reported significant reduced choroidal thickness after high-dose steroid treatment. 25 , 26 We believe that corticosteroid treatment given after renal transplantation does not increase choroidal thickness. Future studies on isolated postoperative treatment regimens after renal transplantation with different patient groups will help form a more accurate assessment.…”

Section: Discussionmentioning

confidence: 90%

Choroidal Vascularity Index and Choroidal Thickness Changes Following Renal Transplantation

Aksoy¹,

Asena²,

Tekindal³

et al. 2023

tjo

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Objectives: This study aimed to evaluate changes in subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), estimated glomerular filtration rate (GFR), mean arterial pressure (MAP), and intraocular pressure (IOP) after renal transplantation. Materials and Methods: A total of 49 renal transplantation patients were included in this prospective study. CVI and SFCT on enhanced-depth imaging optic coherence tomography (EDI-OCT), MAP at the cubital fossa, GFR, and IOP were measured preoperatively and at postoperative 1 week and 1 month. In the analysis of EDI-OCT images, luminal area (LA) and stromal area of the choroid were determined using the image binarization method. CVI was defined as the ratio of LA to total choroid area. The effects of GFR, IOP, and MAP on CVI and SFCT were investigated. Results: The study included 23 women (47%) and 26 men (53%) with a mean age of 26.28±8.25 years (range: 18-52). Changes between preoperative, postoperative 1-week, and postoperative 1-month GFR values, CVI, and SFCT measurements were evaluated. There were significant differences between preoperative and postoperative GFR and SFCT measurements (p<0.001), but no significant differences between preoperative and postoperative CVI (p=0.09), MAP (p=0.14), or IOP (p=0.84) measurements. Conclusion: The present study demonstrated that SFCT increased significantly with GFR, while there was no change in CVI values.

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Section: Discussionmentioning

confidence: 90%

Choroidal Vascularity Index and Choroidal Thickness Changes Following Renal Transplantation

Aksoy¹,

Asena²,

Tekindal³

et al. 2023

tjo

View full text Add to dashboard Cite

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“…On 1 hand, intravenous methylprednisolone pulse therapy was associated with a significant decrease in CT in children with chronic glomerulonephritis 34 and in adults (mean age of 46.8 y) treated with 250 mg of methylprednisolone administered 4 times per day for a total of 3 days 35 . On the other hand, CT was not significantly different from baseline at 1 day, 1 week and 1 month after high‐dose (>500 mg/d) corticosteroid pulse therapy in adults being treated for Tolosa–Hunt syndrome, multiple sclerosis, neuromyelitis optica, optic neuritis, recurrent myelitis, active thyroid‐associated orbitopathy, acute transverse myelitis, cranial nerve palsy or recurrent vestibular neuritis 41 …”

Section: Resultsmentioning

confidence: 99%

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

Yeung

Park

et al. 2022

Brit J Clinical Pharma

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The choroid plays an important role in various ocular pathologies and retinal blood supply. There is a knowledge gap on how the choroid is affected by systemic and topical medications. Systemic medications that affect microvasculature elsewhere in the body can also affect the microvasculature of the choroid. This review summarizes current knowledge on associations between systemic and topical medications and changes in choroidal thickness (CT). This review included 71 studies on mydriatics/cycloplegics, intraocular pressure (IOP)‐lowering therapies, antihypertensives, adrenergic antagonists, statins, corticosteroids, hydroxychloroquine, isotretinoin, hormonal contraceptives, phosphodiesterase inhibitors, antipsychotics, antineoplastic agents, ethanol, caffeine and nicotine. IOP‐lowering therapies, atropine eye drops, and systemic administration of β blockers and ethanol are associated with a significant increase in CT. Cyclopentolate and phenylephrine are associated with a CT reduction. Systemic medications that decrease CT include caffeine and nicotine. Tropicamide, angiotensin‐converting enzyme inhibitors, angiotensin receptor blockers, statins, corticosteroids, hydroxychloroquine and hormonal contraceptives have mixed findings. CT increase associated with IOP‐lowering therapies is possibly achieved by enhancing aqueous humour flow to the choroid thus elevating choroidal blood flow and thickness. CT changes appear to be independent from systemic blood pressure changes, suggesting that a significant association with an antihypertensive could be due to an idiosyncratic drug property. Statins and candesartan decrease macrophage accumulation and intercellular adhesion molecule 1 expression in the choroid. The choroid and its response to various disease processes and systemic medication can be further investigated to improve patient care, particularly in patients with choroid and retina pathologies.

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“…Some studies have shown that systemic corticosteroids affect the blood-retina barrier (BRB) and cause increased choriocapillaris permeability and that systemic corticosteroids are also a risk factor for choroidal vascular hyperpermeability [ 21 , 22 ]. On the other hand, studies on the choroid in long-term use of high-dose corticosteroids have shown a decrease in the choroidal vascularity index, vasoconstriction in the choroidal vessels, and consequently a decrease in choroidal thickness [ 23 , 24 ]. In our study, in line with the literature, the choroidal thickness of Covid-19 patients was greater in the steroid-using group compared to the steroid-free group.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Corticosteroid Therapy on Choroidal Thickness in Patients With Covid-19 Infection: A Prospective, Comparative, and Observational Study

Sönmez¹,

Evereklioglu²,

Yüce³

et al. 2022

Cureus

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Background: Coronavirus disease 2019 has many different ocular manifestations. This study evaluates the effects of the disease and the steroid used in this disease on ocular structures.Purpose: To evaluate the effects of Covid-19 and the steroids used in the treatment of severe infection on ocular structures and choroidal thickness.Methods: This prospective study included 76 eyes of 76 patients who were hospitalized due to Covid-19 and 30 eyes of 30 healthy volunteering controls. Group I included 35 eyes who were hospitalized due to moderate-to-severe involvement that received steroid treatment, group II included 41 eyes with moderate involvement that did not require steroid treatment, and group III included 30 eyes with age-and gendermatched control subjects. Ophthalmological examination and imaging results of the patients obtained in the third week and third month after the diagnosis were compared between the groups.Results: Mean age of all participants was 40.2 ± 6.1 years. In the third week after the diagnosis of Covid-19, choroidal thickness in all regions (subfoveal, nasal, and temporal) was significantly greater in group I than in group II (for all, p<0.001). Moreover, choroidal thicknesses were significantly higher in group I and group II than in the control group (for all, p<0.001). In the third month, all the groups had similar choroidal thickness values (for subfoveal, nasal, and temporal; p=0.058, p=0.111, p=0.079, respectively). Conclusion: Our findings showed that Covid-19 infection causes choroidal thickening by affecting the choroidal layer and that steroid treatment further increases this thickness in the acute period. In addition, the reversal of this thickening to the normal level within a period of three months indicates that the effect of the disease on the choroid is reversible.

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Choroidal changes in eyes treated with high-dose systemic corticosteroids for optic neuritis

Cited by 6 publications

References 24 publications

Choroidal Vascularity Index and Choroidal Thickness Changes Following Renal Transplantation

Choroidal Vascularity Index and Choroidal Thickness Changes Following Renal Transplantation

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review

The Effect of Corticosteroid Therapy on Choroidal Thickness in Patients With Covid-19 Infection: A Prospective, Comparative, and Observational Study

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